How the pandemic has been handled in care homes

The coronavirus crisis in care homes has lead to scrutiny of the Government’s approach to limiting the spread of infection among residents and staff.

Labour leader Sir Keir Starmer has accused it of being “too slow” to protect people, pointing to the timing of official guidance.

But the Government has challenged his claims and rejected suggestions it was slow to respond to the pandemic.

Here are some of the key dates showing how official policy has evolved around the handling of the Covid-19 outbreak in care homes:

February 10 – According to notes from a meeting held by The Scientific Advisory Group for Emergencies (Sage), experts believed that there was “a realistic probability that there is already sustained transmission in the UK, or that it will be become established in the coming weeks”.

February 25 – The Government publishes guidance which twice states it is “very unlikely” that people receiving care in a care home or the community will become infected.

But the start of the guidance says it is “intended for the current position in the UK where there is currently no transmission of Covid-19 in the community.”

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(PA Graphics)

It was withdrawn on March 13.

March 5 – England’s chief medical officer Professor Chris Whitty tells MPs it was “highly likely” there is “community transmission” of coronavirus in the UK.

March 10 – England’s deputy chief medical officer Dr Jenny Harries says the start of the UK peak of the coronavirus epidemic was expected within the next fortnight.

March 12 – According to the Office for National Statistics (ONS), by this date there had been 31 coronavirus-related deaths in England, including one in a care home.

Coronavirus – Thu Apr 23, 2020
Sir Patrick Vallance (PA Video/PA)

Sir Patrick Vallance, the Government’s chief scientific adviser, says the actual number of people infected in the UK at that time could be between 5,000 and 10,000.

March 13 – Initial guidance from Public Health England (PHE) advises care homes to review their visiting policy by asking those who are unwell to stay away and emphasising good hygiene for visitors. On site contractors should also be kept to a minimum.

The guidance says any review should consider the positive impact of seeing friends and family on residents.

March 17 – NHS Trusts are asked to “urgently discharge all hospital inpatients who are medically fit to leave” to help free up critical care capacity for those seriously ill with Covid-19.

Two days later government guidance is published detailing how this can be implemented.

It says Covid-19 test results should be included in documentation that accompanies the person on discharge.

March 21 – Government guidance is issued aimed at helping shield and protect people defined on medical grounds as extremely vulnerable from Covid-19.

Prime Minister Boris Johnson (Stefan Rousseau/PA)

March 23 – Prime Minister Boris Johnson announces the strict nationwide lockdown is to begin, with people only allowed to leave home for essential reasons.

April 2 – Government guidance to care homes says “negative tests are not required prior to transfers/admissions into the care home”.

It says all patients can be safely cared for in a care home if guidance on infection control is followed.

The guidance also states that family and friends should be advised not to visit care homes, “except next of kin in exceptional situations such as end of life”.

April 15 – The Government publishes its Action Plan For Adult Social Care setting out its approach for controlling the spread of infection in the sector.

It confirms a move to put in place a policy of testing all residents prior to admission to a care home.

Where tests are negative it still recommends isolation for 14 days.

It acknowledges some care providers will be able to accommodate confirmed Covid-19 through isolation strategies, while local authorities will be asked to find alternative accommodation for those providers that cannot.

April 28 – Health Secretary Matt Hancock announces that care home residents and staff together with NHS patients and staff can now get a coronavirus test, whether they have symptoms or not.

The Health Secretary also says it is “unreasonable” to be asked to apologise to bereaved families of coronavirus victims over the Government’s handling of the pandemic’s impact in care homes.

Coronavirus – Fri May 15, 2020
Health Secretary Matt Hancock (PA Video/PA)

Professor John Newton, coordinator of the national testing effort, says 25,000 residents in care homes have been tested with it being rolled out to symptomatic and asymptomatic residents.

May 13 – Mr Johnson announces a £600 million package for coronavirus infection control in English care homes as he admits that the number of deaths among residents has been “too high”.

The ring-fenced funding, which also aims to cover homes’ additional staffing costs, comes with the condition that managers restrict permanent and agency staff to working in only one care home where possible.

In the House of Commons, Sir Keir accuses the Government of being “too slow to protect people in care homes”, referencing the February 25 guidance which said it was “very unlikely” that those in a care home or the community will become infected.

Mr Johnson accuses Sir Keir Starmer of “selectively and misleadingly” quoting the guidance by leaving out the line saying it was based on the then position that there was no community transmission of Covid-19 in the UK.

May 15 – Mr Hancock says that every care home resident and staff member will have been tested by early June.

He also announces that a named clinical lead for every care home in England.

The Government publishes a document detailing support for care homes during the pandemic, highlighting the risk of asymptomatic transmission of Covid-19.

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A road sign featuring elderly people (Sean Dempsey/PA)

Data from the ONS reveals that more than 12,500 people living in care homes have now died with Covid-19, with the majority dying in their care home.

May 18 – The Guardian newspaper claims a leaked PHE study found workers who transmitted coronavirus across six care homes were brought in to cover for staff who were self-isolating.

It alleges the Government knew about the results of the study conducted over the Easter weekend in April since the end of that month, but they were only circulated to care home providers and councils last week.

Care homes are working around the clock to keep their staff, and the vulnerable people in their care, safe.

Our ‘Spotlight on..’ briefing focuses on the #covid19 impact on care homes and refutes trusts knowingly transferred COVID patients into care homes

— NHS Providers (@NHSProviders) May 19, 2020

May 19 – A report from NHS Providers says suggestions that NHS trusts knowingly and systematically discharged Covid-19 patients into care homes to free up beds are “damaging and mistaken”.

It says trust leaders consistently followed Government guidance and only discharged known or suspected coronavirus patients if care homes had capacity to safely care for them.

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